pammyf

pammyf

RN,CHPN (Certified Hospice Nurse)

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All Content by pammyf

  1. "butter bullets"--narcotics mixed with butter for rectal administration

    pammyf posted a topic in Hospice, Palliative

    Have any of you used butter, which when cold molds like a suppository? When a patient is no longer able to swallow, but still requiring larger doses of pain meds, and when IVs are too costly, I use...

  2. "butter bullets"--narcotics mixed with butter for rectal administration

    pammyf replied to pammyf's topic in Hospice, Palliative

    Hi Nameste (BTW-I have spent YEARS in India!) I totally relate to you about "hello they are dying....", And as for the glycerine suppositories. Now, that it a GREAT idea! Our hospice is connected...

  3. "butter bullets"--narcotics mixed with butter for rectal administration

    pammyf replied to pammyf's topic in Hospice, Palliative

    They work well. The thing is the FDA has not given it its stamp of approval. Methadone is well documented to work rectally. But not in butter--although quite frankly unless they have a allergy to milk...

  4. Loaded gun

    pammyf replied to indianahope's topic in Hospice, Palliative

    Story one: I had a patient with some sort of civil war gun by his bed. I requested that his family removed it. I was assured they did, but guess what, he used it on himself. He was a very old man and...

  5. Getting certified in Hospice, what is the benefit to you?

    pammyf replied to ShayRN's topic in Hospice, Palliative

    I am certified. The test is about 300 bucks if you join the hospice and palliative nsg association....which is about 75 bucks to join...My work place reimbursed me, and they gave me a thousand dollar...

  6. "butter bullets"--narcotics mixed with butter for rectal administration

    pammyf replied to pammyf's topic in Hospice, Palliative

    When I give a pill or two of course I just use lubrication from a water based thing like lubriderm. But if a patient has 300 or 400 mg of morphine or 40mg plus of methadone (they are horse pills!)...

  7. roxanol in neb treatments

    pammyf replied to lesrn2005's topic in Hospice, Palliative

    Works really well in some cases. Remember to always have patient take po prior to first nebulized administration. There is a potential for a very bad reaction so if roxanol goes into the lungs death...

  8. A blessing in disguise?

    pammyf replied to AtlantaRN's topic in Hospice, Palliative

    Golly, when you have to deal with a 3d party such as a nursing home, and the nursing home is trying to look good even though they are negligent of pericare, and dump that on as your responsibility it...

  9. Hospice Certification exam

    pammyf replied to Brightonrn1's topic in Hospice, Palliative

    bummer!! so close but too far! hey, sorry about the red. cannot get out of it! you can pass it for sure after all your experience with it first time around. i know what you mean about the strange...

  10. Hospice Certification exam

    pammyf replied to Brightonrn1's topic in Hospice, Palliative

    Your 4 years should provide you with a great knowledge base in order to pass. I can give you this advise: Use the sequel to the core cirruculum test questions book. There are about 400 question,...

  11. On A Roll

    pammyf replied to rngolfer53's topic in Hospice, Palliative

    the Febreeze ritual, along with the lab jacket heist is hysterical! It reminds of the breast feeding years when i would drive down to a lonely river bank to "pump". Lord, what we have to do as hospice...

  12. Hospice charting (Neg- Charting) ?

    pammyf replied to Joebrown's topic in Hospice, Palliative

    it seems like things maybe have changed from this interchange. But actually our mission is to help pts. It is just that in hospice we are helping symptoms and the dying process be gentle loving and...

  13. Hospice charting (Neg- Charting) ?

    pammyf replied to Joebrown's topic in Hospice, Palliative

    Sounds like a linguistic issue. Patients are supposed to be declining; however minimal the decline might be in some cases.The "iffy" patients are the ones that careful attn be paid to negative...

  14. On A Roll

    pammyf replied to rngolfer53's topic in Hospice, Palliative

    RN golfer, your letter is really, really funny! Hospice nurses are such a kick! I just started viewing and interacting on allnurses.com yesterday. it is informative and fun and educational! I...

  15. Questions on Cadd pump

    pammyf replied to Rnmomajmj's topic in Hospice, Palliative

    hi, the ratio of po to iv morphine is 3 to 1. Subq should not alter the ratio since it is going directly into the blood stream via tissue and not thru the gut (thus the first pass issue is naught)...

  16. Hospice Certification exam

    pammyf replied to Brightonrn1's topic in Hospice, Palliative

    i just took the exam yesterday. it was definitely not easy. Your experience is key to passing. the study guide questions is the most helpful way to study because then you can see what you may be...

  17. tachypnea symptom.

    pammyf replied to oncalllorraine's topic in Hospice, Palliative

    Morphine is the answer. But you tried to express that there may have been some other factors which were not evidence based which precluded your feeling morphine was what your pt needed. That happens...

  18. Do you attend viewings? or funerals?

    pammyf replied to AtlantaRN's topic in Hospice, Palliative

    I hear what you are saying about funerals. After developing some intense and short term meaningful relationships with pts/caregivers, I used to feel I was obligated to go. Its true it feels "right"...

  19. hospice certification exam

    pammyf posted a topic in Hospice, Palliative

    I just took the exam offered through the american hospice and palliative board (RN) It was a challenge! I was surprised that the results came through the minute I walked out of the examination room....

  20. How Hard Is It To Get In TO Hospice Nursing?

    pammyf replied to bonnie west's topic in Hospice, Palliative

    Our hospice will not hire a new grad with less than 1 year. I have been a hospice nurse for 12 years. My experience is that without a good year or 2 of full time nursing your skill level may still...